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Looking at plan attributes

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Here’s what to look for when selecting among the health insurance offerings in the marketplace. (Important note: the federal legislation known formally as the Patient Protection and Affordable Care Act, discussed in the next section, impacts a number of these issues.)

 Major medical coverage: A good health insurance plan covers the big potential expenses: hospitalization, physician, and ancillary charges, such as X-rays and laboratory work.

 Choice of healthcare providers: Plans that allow you to use any healthcare provider you want are becoming less common and more expensive in most areas. Health maintenance organizations (HMOs) and preferred provider organizations (PPOs) are the main plans that restrict your choices. They keep costs down because they negotiate lower rates with selected providers. The main difference is that PPOs still pay the majority of your expenses if you use a provider outside their approved list. If you use a provider outside the approved list with an HMO, you typically aren’t covered at all. Although HMO and PPO plans do offer fewer choices when it comes to providers, surveys show that customer satisfaction with these plans is comparatively good.

 Deductibles and co-payments: To reduce your health insurance premiums, choose a plan with the highest deductible and co-payment folks can afford. As with other insurance policies, the more you’re willing to share in the payment of your claims, the less you have to pay in premiums. Most policies have annual deductible options (such as $250, $500, $1,000, and so on) as well as co-payment options, which are typically 20 percent or so. When choosing a co-payment percentage, know that insurance plans generally set a maximum out-of-pocket limit on your annual co-payments (such as $1,000 or $2,000); the insurer covers 100 percent of any medical expenses that go over that cap.Note: Most HMO plans don’t have deductible and co-payment options. Most just charge a set amount — such as $25 — for a physician’s office visit.

 Guaranteed renewability: You want a health insurance plan that keeps renewing your coverage without you having to prove continued good health. If you could guarantee good health, you wouldn’t need health insurance in the first place.

Small Business Taxes For Dummies

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